A Scoping Review of Socioeconomic Factors in Orofacial Cleft Research

Abstract

Objective

To map and synthesize evidence on the relationship between socioeconomic status (SES) and orofacial clefts (OFC), identifying key SES indicators, study designs, and evidence gaps to inform future research and policy.

Design

Scoping review following Arksey and O’Malley's framework and reported per PRISMA-ScR guidelines.

Setting

Systematic searches of PubMed, Scopus, and Web of Science with no date or language restrictions.

Patients/Participants

Peer-reviewed studies of individuals with non-syndromic OFC that explicitly measured at least one SES indicator (income, education, occupation, insurance status, area-level deprivation index, or composite SES index).

Interventions

Not applicable.

Main Outcome Measure(s)

Identification and charting of SES measures, study characteristics (design, setting, sample size), and domains of SES–OFC associations (eg, access to care, OFC risk).

Results

Of 259 retrieved records, 42 studies met inclusion criteria. Publications increased over time, with 78.6% conducted in high-income countries (50.0% in North America). Retrospective designs predominated (59.5%). The most common SES indicators were demographic factors (61.9% of studies; race/ethnicity in 52.4%) and household income (42.9%). Two principal domains emerged: SES impact on access to multidisciplinary OFC care (45.2% of studies; all reporting greater barriers for low-SES groups) and SES as a risk factor for OFC (33.3%; most finding increased risk with lower SES).

Conclusions

SES research in OFC is expanding but remains concentrated in high-income settings with diverse measures. Harmonized core indicators—LMICs included—and longitudinal, registry-based studies are needed. Findings support targeted policy interventions (eg, subsidies, resource allocation) and routine SES screening in OFC care pathways to promote equitable access.